Substance use attitudes and behaviors at three pharmacy colleges

Report of the 2020 Special Committee on Substance Use and Pharmacy Education

EXECUTIVE SUMMARYThe 2020 Special Committee on Substance Use and Pharmacy Education was charged to update the work of the 2010 Special Committee on Substance Abuse and Pharmacy Education Report (SAPER) specifically with recommendations on core curricular content and delivery processes on substance misuse and substance use disorder (SUD). This report provides information on the committee's process to address the charges, background information and resources pertaining to the charges, and rationale for SUD being a critical topic for curriculum at colleges and schools of pharmacy. This committee offers several recommendations to the Association of Colleges of Pharmacy (AACP) pertaining to the committee charges.

Effect of waterpipe dependence on risk motives, attitudes and other health-related risky behaviors in Lebanese university students

Explore whether waterpipe dependence in young Lebanese adults would have any effect on modifying the association between risk conception, attitude, and other risky behaviors. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese university students (3384 students). Waterpipe dependence was associated with higher association of alcohol dependence and cigarette dependence by 76.7% and higher excitement for dangerous behaviors by 7.1%. It was significantly associated with increased association of cigarette dependence and alcohol dependence by 66.8%, with the thinking of a behavior of being not dangerous by 239%, with having motives for risky behaviors by 74.1%, with ever having unsafe sex by 111.74%, and between having motives for risky behaviors and ever having unsafe sex by 61.95%. Waterpipe dependence was associated with higher motives, excitement, and perception of risk and risky behaviors, namely cigarette dependence, alcohol dependence, and unsafe sex. Moreover, it was associated with higher risky behavior interdependence.

Use of Psychotropic Medications and Illegal Drugs, and Related Consequences Among French Pharmacy Students - SCEP Study: A Nationwide Cross-Sectional Study

Background: The use of psychotropic medications and illegal drugs is a worldwide public health issue, leading to addiction, psychiatric and somatic disorders, and death. Pharmacy students are more exposed to psychotropic medications than other students (non-medical), which could lead to an overuse. The main objective of this study was to assess the prevalence of psychotropic drug use (medications and illegal drugs) by French pharmacy students, by carrying out a nationwide cross-sectional study. The relation of these medications and illegal drug use with several comorbidities and academic achievement was also assessed.

Methods: This online survey was performed by emails sent to all French pharmacy faculties over a period of 66 days (March 16, 2016 to May 20, 2016). The survey assessed the prevalence of uses of psychotropic medications and illegal drugs during the last 3 months. These uses were compared to student characteristics (personal and university) and comorbidities (anxiety, depression, stress, and fatigue).

Results: Of the 2,609 questionnaires received, 2,575 were completed and useable for the analysis. Among French pharmacy students and during the 3 last months, 9.4% have used psychotropic medications, 21.5% illegal drugs and 3.3% both psychotropic medications and illegal drugs. Psychotropic medications were used in the cases of a medical prescription (49.0%), a self-medication (42.4%) or a non-medical intent (26.3%). Stress scores of the last 7 days were higher for psychotropic medication users compared to non-users and illegal drug users. Proportions of anxiety and depression at the time of answer were higher for psychotropic medication users than for non-users and illegal drug users. Fatigue scores of the last 7 days were lower for illegal drug users compared to non-users and self-medicated students. Annual average marks of the last year, attendance and perception of study difficulty were lower for illegal drug users than for non-users.

Conclusion: French pharmacy students were less exposed to psychotropic medications and illegal drugs than the general French population. However, in comparison to other students in other countries, the use of psychotropic medications seemed to be lower, but with a proportionally higher use of anxiety/sedative medications and a lower use of opioid medications.

Hookah Use Among College Students: Recent Use, Knowledge of Health Risks, Attitude and Reasons for Use

Notwithstanding the efforts of health educators and other health professionals regarding tobacco and smoking cessation, research indicates that hookah smoking among college students remains a health concern. Research shows an upward trend in college students' hookah use. The purpose of this study was to identify and describe potential patterns/differences in college students' hookah use, and the relations among attitudes toward and knowledge about hookah use and use of this drug. A four-page, 20-item survey was used to collect data from participants (N = 403) and to measure participants 'recent use, knowledge of health risks, attitudes and reasons for hookah use among college students. Results indicated increased prevalence rates (53.8%) among participants of this study. Participants' recent hookah use was consistent with that of current research. Study findings supports current research, which found that college students have low negative perceptions of the health risks (addictive and detrimental properties) of hookah use. Analyses also determined that college students' attitudes toward hookah was associated with use of this drug. Regarding reasons why students may use hookah, data analysis indicated statistical significance in lifetime hookah use based on reasons for use. Study provide information for health educators creating hookah risk awareness educational programs aimed at reducing rates of hookah smoking among college students.

Substance Use Attitudes, Behaviors, Education and Prevention in Colleges of Pharmacy in the United States

This review describes and summarizes student pharmacists' substance use behavior in the United States. Current literature indicates that there are problems with alcohol and other drug use among student pharmacists. Although researchers have found variations in the type and rate of reported substance use, significant proportions of student pharmacists were identified as being at high risk for substance use disorders (SUDs). Findings from this review suggest that pharmacy schools should encourage and stimulate more research in order to implement effective screening and early intervention programs in an effort to address this important student health issue.

Alcohol, cigarette, and illegal substance consumption among medical students: a cross-sectional survey

This study investigated addictive substance use by French medical students. A cross-sectional survey was distributed to 255 participants randomly selected from 1,021 second- to sixth-year medical students. Questionnaires were self-administered and included questions on sociodemographic characteristics, mental health, and alcohol (The Alcohol Use Disorders Identification Test [AUDIT test]), tobacco (Fagerstrom test), and illegal substance consumption (Cannabis Abuse Screening Test [CAST test]). The AUDIT scores indicated that 11% of the study participants were at risk for addiction and 21% were high-risk users. Tobacco dependence was strong or very strong for 12% of the participants. The CAST score showed that 5% of cannabis users needed health care services. Cannabis users were also more likely than non-users to fail their medical school examinations (89% vs. 39%, p<.01). One quarter of medical student participants (n=41) had used other illegal drugs, and 10% of study participants had considered committing suicide during the previous 12 months. Psychoactive substance consumption by French medical students requires preventive measures, screening, and health care services.

Pharmacy Students' Knowledge and Attitudes Regarding Medical Marijuana

OBJECTIVE

To determine pharmacy students' knowledge of and attitudes toward medical marijuana and to determine if pharmacy students need additional education on the topic.

METHODS

Pharmacy students were asked to complete a survey on medical marijuana that assessed their knowledge of, medical uses of, adverse effects with, and attitudes toward medical marijuana through 23 Likert-scale questions.

RESULTS

Three hundred eleven students completed the survey. Fifty-eight percent of the students felt that medical marijuana should be legalized in all states. However, the majority of students did not feel comfortable answering consumers' questions regarding efficacy, safety, or drug interactions related to the substance. Accurate responses for diseases or conditions for permitted medical marijuana use was low, with only cancer (91%) and glaucoma (57%) identified by more than half the students.

CONCLUSION

With an increasing number of states adopting medical marijuana use, pharmacy schools need to evaluate the adequacy of medical marijuana education in their curriculum.

Alcohol use behaviors among pharmacy students

OBJECTIVE

To identify reasons for drinking, determine the patterns of alcohol abuse, and explore relationships between drinking motives and alcohol abuse patterns in pharmacy students.

METHODS

A cross-sectional anonymous, voluntary, self-administered paper survey instrument was administered to first-year (P1) through third-year (P3) pharmacy students as part of a professional seminar.

RESULTS

Survey instruments were completed by 349 pharmacy students (95.9% cooperation rate). Using the Alcohol Use Disorders Identification Test criteria, 23.2% of students reported hazardous or harmful use and 67.2% of students reported consuming alcohol at hazardous levels during the past year. Students who were male (37.0%), single (25.3%), and attended the main campus (26.2%) were more likely than their counterparts to report hazardous or harmful alcohol use. Pharmacy students reported social motives as the most common reason for drinking; however, coping and enhancement motives were more predictive of harmful or hazardous alcohol use.

CONCLUSION

Approximately 1 in 4 pharmacy students (23%) reported hazardous or harmful alcohol use. Education about the dangers of alcohol abuse and intervention programs from colleges and schools of pharmacy are recommended to help address this issue.

The development of the student pharmacist chemical health scale (SPCHS)

Background: The Student Pharmacist Chemical Health Scale (SPCHS) is a tool designed to evaluate substance use behaviors and risk factors for substance abuse among student pharmacists. Methods: It was administered to a sample of student pharmacists at the University of Georgia (UGA) as a preliminary component of a longitudinal study evaluating student pharmacists nationwide. Results: This final scale was found to have a high degree of internal consistency and showed appropriate content and face validity for the domains tested. Conclusions: Future analyses will center on further validating the SPCHS in known groups of pharmacists with substance use disorders.

Patterns of substance use initiation among healthcare professionals in recovery

BACKGROUND AND OBJECTIVES

Substance-related impairment among healthcare professionals has significant public health implications, but little is known regarding factors associated with substance use initiation in this group.

METHODS

In this study, 105 healthcare professionals (80% male), who ranged in age from 24 to 68 years (M = 47.1 years, SD = 10.2) completed a self-report questionnaire assessing age at first use, education level at first use, means of access to substances upon first use, order of substance use initiation, and reasons for first and continued substance use. Physicians (51%), pharmacists (19.2%), dentists (11.5%), physician assistants (5.8%), and various other allied health professionals (12.7%) participated.

RESULTS

Results demonstrated that 73.2% of the professionals used tobacco, 90.4% used alcohol, and 64.4% used other drugs before beginning professional school. Reasons for first use of substances paralleled those seen in the general public (e.g., curiosity, peer influence, availability), and differed from reasons for continued substance use (e.g., getting high, addiction, stress management).

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

Given that onset of substance use among health professionals appears to mirror that seen in the general population, their unique treatment success rates likely cannot be solely attributed to later age-of-onset of their substance use disorder. Delaying experimentation with addictive substances and improving efforts at early identification of problematic use are crucial to preventing the development of substance use disorders among healthcare professionals, as well as the public as a whole.

Tobacco, marijuana, and alcohol use in university students: a cluster analysis

OBJECTIVE

Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use.

PARTICIPANTS

The authors used 2008-2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions.

METHODS

The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined.

RESULTS

Cluster analysis yielded 6 distinct clusters. Three individual factors--gender, year in school, and fraternity/sorority membership--were the most strongly associated with cluster membership.

CONCLUSIONS

In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach.